The Case for Physician Coaching: From Anecdotes to Evidence with Dr. Tyra Fainstad and Dr. Adrienne Mann | Ep20

Michael Hersh, MD

[00:00:00] 

Okay, now be honest. When you first heard other physicians talk about coaching, did you roll your eyes? A little. Same. Most of us were trained to be skeptical and trust randomized controlled clinical trials. And yet what if there's actual real data that coaching lowers burnout, quiets that lurking imposter syndrome, and helps us feel more human in our work again?

Again, today we're talking with two physicians who put physician coaching under the proverbial microscope and didn't just find anecdotes. They found evidence. If you've been curious, skeptical, or a little bit of both, this episode's for you.

Well, hey everyone, and welcome to another episode of the Better Physician Life Podcast. Thank you so much for being here today. So today I am super excited to be joined by Dr. Adrienne Mann and Dr. Tyra Fainstad. But before we dive into this conversation, [00:01:00] I'd love to start with some introductions.

So Dr. Mann is a hospitalist at the Rocky Mountain Regional VA, and Dr. Tyra Fainstad is a primary care physician and resident clinic director at the University of Colorado. Together, they co-direct Better Together, a physician coaching program that started small and has grown into one of the largest studies ever done on coaching in medicine.

Their shared work is about helping physicians move beyond burnout, quiet imposter syndrome, and find a healthier way to thrive, both in medical training and in clinical practice. Adrienne and Tyra, welcome to the show. Oh my gosh. Thank you so much. What an intro. Absolutely. Well, you both have done so much incredible work in the space of physician coaching, but before we dive into that, I think we all had that moment before we found physician coaching where we heard people talking about it and [00:02:00] thought, this is not for me.

I know for sure that was my experience. Tyra, can you tell me a little bit about your experience with finding physician coaching, and were you skeptical when you first heard about it? Yes. That is literally my come-to-coaching story is one of skepticism. It was back in the early 20 teens, 2014, 2015, and I was a.

Pretty new junior faculty member over at the University of Washington, and I was sort of hitting rock bottom professionally and personally for many reasons, including career burnout. And I had two small kids and was trying to get my feet under me as a mom and a wife and a doctor, and potentially a researcher.

And none of it was working out the way that I thought it would when I was in training. I. Remember the day still that I had a friend who was going through coach certification and she reached out to me very tentatively to ask if I would [00:03:00] let her coach me in return for some feedback on the call. And I still remember the feeling where I sort of rolled my eyes and like almost felt sorry for her that she was doing this.

'cause it was like, really? Oh. What is coaching like that's not a real thing. That sort of sounds like a glorified cheerleader. There is no way that this is gonna be successful for you. But it was a dear friend and so I rolled my way into the conversation and said, yes, of course I will do this for you.

And I always say, honestly. More in my life changed in that hour-long conversation than probably in the prior decade. I couldn't believe it, and I came at this, you know, doctors tend to go down a rabbit hole on problems. I had felt myself flailing and had reached out in all different directions to find an answer I had.

Gathered up all my [00:04:00] mentors and I had tried some SSRIs and I had gotten a therapist that didn't go well. And not that I have anything against all of those things, they certainly have their place. But for the brain destruction that was happening to me, none of them were really fitting the need.

And had developed a healthy skepticism around mental health and wellbeing for myself. So I was completely floored in that conversation. Very surprised. Came out of it, got a lot of coaching on my own and came outta that really grateful that I had found this tool and that I had learned the lessons I had learned, but also pretty angry that these tools weren't taught to major in medical training or, even in junior faculty.

It seems wild that. Process of like naming and allowing an emotion is not a skill that is taught to doctors. So that's what I came at Better Together with Adrienne. And then how did you two, 'cause Adrienne, I think [00:05:00] you have a similar story. How did the two of you end up combining forces?

Yeah, I could take that one. My story is very similar and it comes a little bit with. A caveat that I had not been recognizing myself in a lot of domains I was in for a long time, and so I came back from having my second kid had pursued institutional leadership, medical education, leadership. Parenting, trying to keep my marriage and my family happy all the time.

And I didn't recognize myself really in any of the work I was doing or also in my body. So I came to coaching primarily through a group of women physicians who were trying to lose weight. And I learned about how. Understanding my mind and my reasons for eating transformed my relationship, not only with food and my body, but also with everything else in my life.

So I started as a skeptic also, but then through, I think kind of desperation [00:06:00] came to coaching. I consumed hundreds of hours of podcasts like yours, and then finally made some substantial investments in myself and changed. My life. Tyra and I were going on that journey right around the same time, and we have a mutual friend from medical school who said, you guys are doing the same thing.

And this was right when Tyra was about to move back to Colorado. From Seattle. And so, we set up a meeting and we said, do you know this person? And do you know that person? And have you listened to this podcast and are you also gonna get certified as a coach? And I had written a grant an internal grant here at the Department of Medicine, and Tyra had gotten an award through SGIM.

And so we kind of combined those forces to use those resources to build better together And it's just the most rewarding and fulfilling professional effort I've ever had. And so it just was the stars aligning. Yeah and so, you know, I think it's important to remember our skeptical selves. 'cause for sure, this is [00:07:00] my story as well.

I remember, you know, tuning into a group coaching call, signing off and being like, no way, right? this isn't for me. And then subsequently leaning into the discomfort of if I don't do this. My life doesn't change, right? If I don't try to do something different than what I'm currently doing, then I just am gonna keep getting the same result, which is my current life, which I was great, but I wasn't super happy in.

Yep. And so. I always try to bring myself back to that skeptical person because I can imagine there are physicians that are listening to this and being like, yeah, yeah, this is three doctors who found physician coaching, and now they're talking about it from their current standpoint, but is this really gonna work for me?

And what I love? About the work that both of you have done is that it doesn't rely on the anecdotes of individual doctors on their experience with physician coaching. The two of you have taken it to the [00:08:00] next level. I'd love for you to tell us more about the work that you've been doing over the last couple of years.

Oh my gosh it's such a wild experience every time we talk about the last five years because there's just no way, myself, five years ago could have predicted the amount that we have grown, but I think that actually skepticism really laid the foundation for, or at least gave the why for why we went the direction that we did with the coaching program.

There are a lot of really fantastic coaching programs out there that everybody knows works by being in them and haven't been necessarily studied rigorously. And so I think we built better together for the skeptics at least. That was a huge driver for me in evaluating it as rigorously as we have the physician coaching community out there is highly variable.

It's still currently unregulated. It's not a regulated [00:09:00] industry, and that leaves many of us doctors feeling really uncomfortable. I think myself and Adrienne included, because we are used to just the most regulated industry and every single decision we make all day, every day is supported by. Decades of evidence to or against it.

And so he enter this very valuable and helpful facet into the industry, but there's just no evidence. It feels that discomfort, I think is what we were aiming to mitigate with the design, or at least the evaluation of Better Together. So we built this program for the specs, or I should say we evaluated this program for the skeptics.

Yeah, we built for our past selves for the versions of us who really needed it. Would it be helpful if I describe the program real quick and then we can describe the research that we've done? Would that make sense? Okay, so what Better Together now is a web-based group coaching program that started among, women, [00:10:00] GME trainees at the University of Colorado.

Tyra's gonna explain how we studied it among that population and then among a national population and how we've grown since then. But now we are a nationwide coaching program for physicians and physicians in training as well as advanced practice providers and researchers. Across the country. So I think we're at 60 sites and we partner with institutions to make this program available to their population.

And folks can opt into the program, which runs twice per year. It's four month cohorts and includes a bunch of different coaching opportunities. Live group coaching calls, like Michael, what you described earlier. We have some one-on-one coaching opportunities, some self-study materials, and written coaching on our membership site.

And what's really cool is all the participants get to join. Anonymously and confidentially. So their site never hears, oh, you know, Dr. Jones participated in Better Together and they complained about this or that, Nope, folks can [00:11:00] come and bring any challenge, professional, personal, or anything and get coached on it here confidentially and better together.

And it's really just a meaningful investment that the institution can make in their physician and clinician workforce. the group coaching aspect I think sometimes causes physicians to be very timid or nervous or maybe not wanting to speak. And I think, these group coaching calls tend to become a community.

And rather than being a gossip mill, they become a place where we see ourselves in the other people who are telling their stories. And it is not so much as Dr. Jones was here, and this is what he said. This is like, oh my gosh, Dr. Jones was here. And yeah, I resonate so much with that exact story, and that is not something that people are going out and talking about.

This is the internal dialogue that people have as they're sitting and observing and realizing, oh wow. It's not just me, [00:12:00] which I think is one of the most incredible things that I personally took away from group coaching because I spent most of my life thinking like, oh, this is just, you put your head down, stop complaining, keep going.

And to sit in a group of other physicians and realize like, oh my goodness, this is all of us. Transformative. Yeah. Our groups are cohorted, so we run a program for medical students, GME trainees, MD, DO, and PhD faculty, and then advanced practice providers. And each of those happen within their own container.

And then, on average, once per week, we have a call for all of those populations to join. But in general, you are absolutely right. Like one of the things that creates psychological safety in the coaching is being among a group of your peers. And it's fascinating to see not only am I. Not alone in experiencing my work the way I am, but also it's not just my institution.

Like there's somebody across the country who also has the same challenge. And so it also takes away that concept of like, it's my place that's broken, [00:13:00] or it's me that's broken. And instead we can look at how like our collective beliefs of what this work means might be part of what's broken . Yeah, I think you just described that, what I would call the secret sauce of group coaching, Michael.

That was a perfect description of it. In fact, our qualitative analysis that we did of a participant experience is titled, it's Nice to Know I'm Not Alone, or We're All Going through It. And that just came up again and again. That normalization and community feel is really, truly, I think what makes this a more impactful program.

Than just a one-on-one program. Absolutely. And still, right? Like, these are essentially anecdotes from the three of us. And then you went and started analyzing. What this experience has been like for your cohorts, and I'd love for you to speak to what you've learned because you've been doing this for a long time now.

Yeah, you could summarize it [00:14:00] by us learning that coaching works for physician wellbeing. Without a doubt, I can say that this is the most rigorously studied wellbeing intervention out there. And when we talk about coaching, working if anybody is familiar with the type of coaching you do, Michael, it is exactly the same type of coaching that we're delivering inside of Better Together.

All of our coaches currently we're trained at the same coaching institution and we're certified in the same way. And so we're delivering this very. Metacognitive or thinking about your thinking type of thought work which is the same type of thought work, of course that you're doing here, Michael.

So I can say that method of coaching. Works for sure. When we first started out, of course, we imagined that we'd offer this kinda like in-person fireside cozy chat to a group of residents here at the University of Colorado, and then the pandemic hit. And that was honestly, of course, a curse in many, many ways, but a blessing.

In terms of [00:15:00] our creativity for how to deliver this program, it forced us to pivot to an all online model, and it allowed us to think a lot bigger than the fireside chat would. And so that first year, we decided to offer this to a hundred people. And when we hit those triple digits, we thought, huh, I wonder if we're allowed to just like randomize these people and run an RCT.

Could we do that? Neither Adrienne and I identified at all as researchers. But of course we're clinicians, so we know what an RCT was. We were putting names through a random number generator in Google. Is that how we randomized them? And the IRB was like, yep, that seems fine. So we just did it.

We somehow. Ran a fully randomized control clinical trial, and compared a half of them, which we enrolled at that time spring cohort to a wait list control who also enrolled. But we said, Nope, hang on a second. We're gonna evaluate you before we [00:16:00] give you the coaching, which then they got in the fall of that year and we measured.

Before coaching and then after coaching for both groups. Uh, metrics of wellbeing, which we still continue to measure every single time we run this. Our main one is burnout, but we also measure imposter syndrome, moral injury, self-compassion, flourishing. We've added on a whole bunch of other wellbeing metrics since then, but those are sort of our mainstays.

And we showed that the people who got coached had a major statistically significant drop. In most of our wellbeing metrics, all three facets of burnout in that pilot study, a curative reduction in imposter syndrome. So most went from having it to then not having it, on that standardized scale. After doing that, we were like, gosh, we could coach people in these virtual Zoom rooms.

You know, we could coach 10 of 'em or we could coach a thousand of 'em. It doesn't matter. We're still sort of going through the same number of [00:17:00] people in front of each other, and so the amount of people that watch or listen to it is the same amount of work for us. So let's just go really big. We scaled up, did the exact same trial with a hundred residents and fellows across the country, showed even more and bigger statistically significant results.

So now we're improving the burnout score. Seven points. Which to my knowledge is like the most points, any wellbeing intervention has taken a burnout score in a group of resident physicians who are notoriously hard to help. And we hit statistical significance in every single outcome we looked at. And just to clarify, that was a thousand?

Because you said a hundred. Oh, a thousand. I'm sorry. It was over a thousand. Over a thousand residents and fellows across the country. 26 graduate medical education programs. So we showed that it's generalizable in that group, and then we started talking with these programs, and they were like, gosh, this is so [00:18:00] great.

Thank you so much. But where is this for the faculty? Where is this for the attendings? Like, we're not, well just because we're not in training anymore. Which of course resonated with us. And so that was the next jump that we made, which wasn't hard. We certainly rebuilt our curriculum to be applicable case-wise for attending physicians, but the thoughts and feelings that attendings deal with are not actually different from, med students and residents.

It turns out that you don't feel much better the higher up you get. And so we ran that. Pilot randomized control trial here in almost 200 faculty physicians at the University of Colorado, and again, showed the same improvements we saw in residents this time. They came to us with bigger improvements in depersonalization.

Residents had bigger improvements in emotional exhaustion. We can pontificate forever on why that might be. But we also helped with imposter syndrome. We improved flourishing, and since then our [00:19:00] research team has grown a ton and we've been able to complete randomized control trials also in medical students at five medical schools across the country and in APPs in two institutions.

And both of those trials also showed positive results. In wellbeing and measures of distress among all those groups. So that's who we coach. Everybody we coach we've shown in an RCT academic goal that this actually works on validated scales. Where we've taken it now is trying to understand why in a scientific way, we know why personally for us, but is there a theme?

Is there some grounded theory analysis we could do? So we're exploring. Recordings of coaching calls. We're exploring one-on-one or focus group interviews with participants. We're exploring really fancy things like mediation and moderation analysis to see if we can find the drivers of wellbeing [00:20:00] and distress, and all these groups, and why coaching might actually help.

In those reasons, it feels like we are studying this with the same. Sort of detective glasses that, like a cancer researcher is trying to understand why is this cell replicating? What exact enzyme is it? It's like, why is this helpful? What exact thought pattern are we nudging in this program? So it's really fun.

It's a lot more interesting to me than cancer cells. That's incredible. I'm curious. So I understand this is an ongoing, evolving body of research, and is there anything that has jumped out at you as you've continued to do this work? Yes. Physician coaching works. And were there unexpected findings or things that you've uncovered that, have been a little bit surprising to you?

Yes. I'll just also say for any listeners out there that are getting ready to fast forward through this 'cause it's so researchy that I also hated research when I started this. Like I thought it was a necessary evil to [00:21:00] function in academia. I wanted to do the bare minimum of it to make my higher-ups happy and would never have listened to a research podcast.

And when you find the right. Topic to be passionate about. My mind has completely changed on that. I feel so interested and excited and curious and energized towards this work. And so if anybody feels like they wanna dip their toe in it, my email will be in the show notes, let me know.

But yeah, there have been some surprises. So while the themes of suffering that. Students, trainees, physicians, even very senior physicians, struggle with, tend to be the same. You know, it's all, some iteration of, I'm not enough. And what does that look like for you is different? What we're able to do with coaching is slightly different in those groups.

And so actually it turns out that medical students are now currently at baseline, much less burned out. Then they have been before. And then their resident and faculty comparators. This is kind of true across national surveys, but so [00:22:00] instead of mitigating their burnout, better together is improving their self-compassion and flourishing in that group, whereas in practicing residents, fellows, and physicians, really working more in the burnout moral injury.

Sort of storm that has been created by a multitude of factors. And so it does hit different facets differently, and that was surprising. I'll let Adrienne say what she was surprised about before I start talking about my current obsession. Okay, cool. I think what I'm surprised about, and Tyra didn't mention this when she was talking about our largest RCT.

The big GME study was that the number needed to take somebody from burnout or imposter syndrome being present to being absent. It was only 10 participants, so only 10 people needed to participate in Better Together to take one person from being burnt out to not burnt out, just like a really, really low number needed to treat.

One of the things we know is that it's actually a minority of people who ever raise their hand for the live or [00:23:00] active components of our program. The vast majority are more passive consumers of the coaching. So maybe they're listening to the podcast but never raising their hand, or maybe they're.

Doing the work on their own, but that's not a metric that we are measuring or capturing. And so one of the things that I'm really surprised by is I know that I get a lot out of coaching by raising my hand and having a conversation, but the number needed to treat, and I think the scale of the impact we had and the measures of distress and wellbeing show us that you don't have to be one of the tiny minority of people who raise their hand in order to get an impact.

That you can be a passive. Participant in coaching, you can listen to it or just read the email and still have transformation in your relationship with work and your thinking around these things. And so that's like huge to me. 'cause I think the majority of people think, okay, I'll sign up for this thing like begrudgingly 'cause I'm a little bit of a skeptic and I don't know what this is all gonna be about and I'm [00:24:00] gonna like, don't count on me to speak up.

But even those people. Have their needle moved. So I love that.

I will pick up from there and just say a sneak peek. As I mentioned into this work of why coaching works, the theme that really kept jumping out at us, across our qualitative endeavors had been that it seems like and we know this from being coaches also, but it seems like we're really helping participants.

Guide towards their inner purpose or what we might call their intrinsic motivation. And physicians are a group of people that are really used to being motivated by external things bosses or supervisors or a paycheck or a patient need or whatever, pre-survey or, a lot of different external drivers hospital systems.

And we know that feels bad. And it's also not sustainable. What I didn't know before I came into this is that having a only extrinsic motivation, [00:25:00] focus is a direct driver of burnout. And so the more we have explored. Helping people identify and fuel their own intrinsic motivation, the better they seem to get.

And it seems like this method of coaching that we all do, that we all employ is particularly good at doing that. And so this all falls under an umbrella of really old theory of wellbeing and learning called self-determination theory. And helping any humans become more self-determined or more intrinsically motivated also helps them.

Flourish helps them have greater wellbeing. And I think that's what we're doing. A lot of the coaching is around unveiling areas where we thought we had no agency or autonomy in our lives and helping people see where they actually do. And it's just their thinking, getting in the way, or we think we're.

Like anybody else, and we're kind of falling into a martyr thought pattern, and all we're doing is unveiling through all the [00:26:00] things Adrienne just said, how we're actually just like everyone else. And then the third facet of this is maybe the most impactful. A lot of people come to us feeling like they're incompetent or inadequate, and a lot of what we're doing is addressing those really strong inner critics and helping find the thought errors inherent in any inner critic that tells you're.

Kind of worthless and not adequate compared to everybody else and helping them reframe those thoughts, or at least bring some awareness to them as not reality. Yeah. I think what you are very much speaking to is how the physician personality develops, right? So it starts with like a gold star in kindergarten where you're like, oh, I get praised for doing a good job.

How do I keep getting praised? We tend to, over the course of our careers, continue to build on the dopamine of achievement and getting gold stars. And as we lean into that kind of external motivations, we build a life that doesn't [00:27:00] always feel entirely like our own. We kind of lose track with who we wanted to be, who we thought we could be.

And I think for physician coaching for me has helped me to reintroduce myself to myself, which sounds very woo. I hear it. And I think if you don't allow yourself to take a step back and really see where are your motivations coming from and what do you really want? You can't really create it, right.

There's no way to do it without actively doing it. And I think that physician coaching gives us the space to do that. And then the other piece that you were just talking about was that inner critic. And I know in my own coaching, my personal coaching that I have received, and in the coaching that I do with physician clients that inner critic can be the loudest thing we hear all day. And I know that in this work self-compassion is a [00:28:00] critical piece in helping people to see like it's okay, like to quiet down that inner critic. Talk to me a little bit about what you have found in terms of self-compassion and the work that you're doing with physicians.

Physicians don't like to be told that they need more self-compassion, so, hundred percent. So we found that if you lead with that, it really can promote people putting their guard up. So we don't usually lead with, Hey, you need more self-compassion. But what we try to do is bring some awareness to the inner critic, try to understand where the inner critic is coming from, why they might have developed the voice they have, why they might have developed the urgency that they have.

Try to do a lot of work of understanding that part. And usually, the inner critic is protective. The inner critic wants 'em to succeed. But the inner critic, when it has the megaphone is the driver of [00:29:00] perfectionism, imposter syndrome, like often disconnection from their values, right? The inner critic drives them to do things, that are often in contrast to what they really, truly want.

And so in our coaching, we don't lead with this is self-compassion work, but we lead with those conversations of like, let's get to know that part of you. Are there other parts that need a seat at the table? What do we need to say to the inner critic to help them share the megaphone? And through that is the process of building self-compassion, understanding oneself more deeply, having patience and grace for those parts that are upset or those parts that need additional.

Like TLC, and through that, it turns out that's the like Trojan horse for building the skill which I think it is. It's a skill and a practice of self-compassion versus what we all have rehearsed for decades and decades, which is the skill of like kind of self-flagellation, choosing the hardest thing, competing the most for it.

Like being deficit focused in our lens towards ourself, [00:30:00] being in competition with others and ourself. And so it really is. Right-sizing, the inner critic with the rest of the other voices. Yeah, and it's so particularly hard in physicians because we have glorified the self-flagellation we've been taught over really like it's been building for centuries, our physician culture that glorifies overworking and a bit of martyrdom and being the hero and the almost a deity like figure.

And so it's tough to underwrite that belief that isn't necessary for us. The inner critic feels very near and dear and possibly like the thing that is saving it. Us or keeping this whole house of cards up. In fact, one of the most widely published physicians that has studied self-compassion.

Dr. Mickey Trockel has changed. The word self-compassion because he was finding that it wasn't lying well with physicians and the readers. and so playing around with different words like self-efficacy and all of these other sort of [00:31:00] adjacent terms. But if you have a conversation with him, he's like, no, what I'm talking about is self-compassion.

It's just doctors don't wanna hear that. 'cause we're actually scared to get rid of the flagellator, like everything will come down. And self-compassion is this like, becomes almost a threat. When really what we know and what you brought up is that the inner critic, of course, is driving this imposter syndrome or this belief that we are inherently not as good as everyone else around us.

In fact, what we proved just recently, one of our coaches, Dr. Kana Kornsawad, published a paper in the Journal of General Internal Medicine looking at the relationship. Between imposter syndrome and our other outcomes, and the most significant inverse relationship that she found was that the more self-compassion you have, the less likely you are to have imposter syndrome.

It is a direct, significant relationship where the other ones are not direct and kind of muddy. These are so clear that if you can build this hard skill of [00:32:00] self-compassion. That inner critic in your imposter syndrome will quiet. We know that to be true. And I'll offer this sounds like a huge undertaking, right?

Like this sounds like, oh, I must develop this, like tremendous self-compassion practice. And sometimes for me the simplest thing I can do is rationalize that any other gastroenterologist in the same exact. Predicament would feel the exact same way, right? If they were doing a colonoscopy and lost sight of the polyp, or if they were handed the wrong tool that they had asked for, or if the thing that they were requesting couldn't be found or any of those things.

These are real-life examples of the things that come up and I might without, wearing my coaching cap, get really frustrated or upset, or why is this always happening to me? Which is a hundred percent how I showed up in a previous version of myself, right? [00:33:00] And when I can remind myself, like, of course I'm frustrated, anybody else would be frustrated in the exact same situation.

A surgeon having their knot cut after they just finished tying it. A patient being 20 minutes late. Any other physician in the same situation, and this is the easiest pathway to just a little bit of self-compassion that can totally turn your day around. And if you can just find a little bit of that, you don't have to call it self-compassion.

You can call it whatever you want. And if you can find it, it really transforms your day. I mean, Michael, what you were just describing is really good friendship. It's like what you would say to somebody who was your friend is you would say like, oh my gosh. Anybody would feel that way if that happened to them, or if this was a thing, but we don't have.

At least most of us haven't practiced building that same relationship of friendship with ourselves. And so it's turning into the friend that you would be to other people or that you are to other people. But just for [00:34:00] you, I mean, it also means you have to allow the frustration to exist. Because you're saying Yeah, it makes sense.

And so you're almost welcoming it into your experience, which is very counterintuitive to doctors who like to. Fix or solve for an uncomfortable experience. So selling people on allowing the frustration to be there as a mechanism to get through it faster and better is tricky and not intuitive. When you really want to fix the circumstance.

So the frustration goes away. And this is a hundred percent where the coaching comes into place, right? Because this work is intuitive and not natural, right? Like this isn't the pathways that have been laid in our brains and how to do things. And I think that is really genuinely where the power of coaching happens.

And I have this discussion with my physician coaching clients, which is. You are gonna come here, we are gonna have a discussion. You are going to resist it. You're gonna go out, you're gonna try it. It's not gonna work. You're gonna come back, we're [00:35:00] gonna talk about it. I'm gonna give you something else that you're gonna try, you're gonna try it, you're gonna resist it, and it comes in iterations.

And in each iteration, we get a little bit closer to showing up how we wanna be showing up. Yeah. What a great evolution of coaching. So true. As we wrap up, are there some major takeaways that you want the audience to walk away from this episode knowing?

Oh man. Okay. even if you're skeptical, you could dip your toes in and you could be fly on the wall. And still get something out of it. So I hope you take that away and I hope you also take away that the more you engage, the more you get out of it. We think that's also true. Oh man. I guess like.

Another thing is that there's never an end to it. Like I feel very grateful to have a community of people around me now also doing the same work. And it's really cool to see how, even though we talk about the same concepts over and over, that those concepts evolve as I move through my life and my relationship and [00:36:00] different things and work.

And so. While it can feel like, oh, there's so much work still to be done. There's a tremendous and supportive community of people who help me do that and continue my evolution and growth. And being part of a program like yours is that so even though sometimes it feels like a huge mountain to climb, like yes, and you get to climb that whole mountain and you do it with other people like you, and it's amazing.

I would leave people with the lesson. I keep learning over and over again. And it was actually that first aha moment to me in that very first coaching call from my friend that I rolled at. And it's the fact that you don't have to believe your thoughts just because you're thinking them. I know.

Which was like, nobody told me that. Excuse me, I thought I'm obligated to believe myself because I've got my brain and you just aren't. And so even if you have a thought, like there's no way my life can get better, which is a thought that I commonly have, and then I'll list out all the reasons everybody else is making my life really hard.

Actually. Just remembering. [00:37:00] That just because I'm thinking this doesn't mean I have to believe it creates, the whole world opens up and that's the lesson that I learned again and again in coaching. So if anyone's having a thought out there that doesn't feel good, I give you permission to just not believe it.

I give it to you. I love that. And I'm gonna offer to you, one of my physician coaching clients summed this up beautifully. He said, my brain sells me stories like they're facts. Yes. And I just thought, wow, I couldn't have said it more eloquently.

Yes. And so you don't have to believe everything, every story that your brain is telling you. And it really, again, can transform everything. And, again, you know, a plug for physician coaching is that. You can be a fly on the wall and your worst case scenario is your current life because if it does work for you, like we are anecdotally telling you and like the data shows [00:38:00] us in your studies, your worst-case scenario is your current life.

But in the best-case scenario, your entire life shifts like it has for the three of us. I would love for you to tell the audience how they can learn more about both of you and better together and your studies and your research. You can find us at bettertogetherphysiciancoaching.com. Through that site you can send us an email.

We're happy to set up a meeting with anybody who wants to bring better together to their workplace. We will send a link for our research page where you can really explore more about what we do when we're not coaching, and we hope to hear from you. Yeah, please reach out. happy to share our institutional email addresses also, and just love hearing stories, hearing reflections.

If you had a big aha thought, those are just the happiest emails that we get. Would love to connect. Amazing. Dr. Adrienne Mann, Dr. Tyra Fainstad. Thank you both so much for being here today. Love chatting with you. And as always, to the [00:39:00] audience, thank you so much for spending some time with us today. I'll see you on the next episode of Better Physician Life.

Take care.